Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 04008 | Date 14/08/2020 |
| Token No | SM/22-23/2592 01/04/2022 | Serial | 013 |
| Patient Name | Mr. SUMIT KUMAR SINGH | Contact No | 9117669972 |
| Address | 22/1 L M B STREET | Age | 18 YRS Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||